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US BOXED WARNINGS FETAL TOXICITYAngiotensin converting enzymeACEinhibitor use during pregnancy can cause morbidity and death to the developing fetusWhen used during the second and third trimestersACE inhibitors have been associated with fetal and neonatal injuryincluding hypotensionneonatal skull hypoplasiaanuriareversible or irreversible renal failureand deathOligohydramnios has also been reportedpresumably resulting from decreased fetal renal functionoligohydramnios in this setting has been associated with fetal limb contracturescraniofacial deformationand hypoplastic lung developmentExposure to ACE inhibitors during the first trimester of pregnancy has been associated with prematurityintrauterine growth retardationpatent ductus arteriosusother structural cardiac malformationsand neurological malformationsWhen pregnancy is detectedACE inhibitors should be discontinued as soon as possibleIf no alternative to ACE inhibitor therapy is availablepatients should be made aware of the risks to their fetuses and the intra-amniotic environment should be evaluated by serial ultrasound examinationsIf oligohydramnios developsthis drug should be discontinued unless it is considered lifesaving for the motherDepending on the week of pregnancycontraction stress testinga nonstress testor biophysical profiling may be appropriateOligohydramnios may not show until after the fetus has suffered irreversible injury.

Some side effects of lisinopril may occur that usually do not need medical attentionThese side effects may go away during treatment as your body adjusts to the medicineAlsoyour health care professional may be able to tell you about ways to prevent or reduce some of these side effectsCheck with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

If you’re trying to get pregnant or you’re already pregnanttalk to your doctor about the benefits and possible harms of taking lisinoprilThese will depend on how many weeks pregnant you are and the reason why you’re taking itThere may be other treatments that are safer for you.

Special SensesVisual lossdiplopiablurred visiontinnitusphotophobiataste disturbancesolfactory disturbances.

During the first few days of taking lisinopril or after increasing the dosestop drinking alcohol until you see how the medicine affects you.

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